What I’ve seen and heard about the National Gender Service in Ireland reminds me of the UK during the 90s. The NGS doesn’t feel like a healthcare service; it feels like a gatekeeping institution run more on ego than on care.

I've lived in Ireland for less than two years at this point, but I transitioned over 30 years ago. Moving here, I talked to my GP about continuity of care (mostly just HRT), and was flatly refused. Though she was personally sympathetic, she told me that she'd been threatened by the National Gender Service not to prescribe, diagnose or refer for anything trans-related. All she could do was put me on their waiting list, which it seems is currently 10 to 13 years. A break in care of that duration would be extremely inappropriate (to say the least) – whilst being traumatic, it would have significant health risks associated with it.

I'm not a shrinking violet. If someone puts up a roadblock, I'll go around it if possible, or demolish it if necessary. I arranged private access to HRT outside Ireland pretty quickly, so I was fine. Paying out of pocket, of course, but fine. My GP will at least do the necessary blood testing, which helps a lot practically.

I've heard, let's say, stories, about the state of trans healthcare in Ireland via the NGS. TheJournal has a current news story running about this (link below).

It reminds me of the bad old days of the Charing Cross clinic in the UK in the 1990s. Possibly even worse. I had a friend back then who was denied GRS because one of the psychs found out that she was in a lesbian relationship. I heard from another who had been held in the system for over 20 years waiting for surgery, seemingly because of a power trip and her not quite being 50s ideal woman enough. I never went there myself, I went elsewhere, but I remember being yelled at because I'd been working in a datacenter at a bank all day, crawling around behind racks fixing a network problem, and hadn't had time to change so I showed up in – shock horror – trousers. Oh, the humanity. Won't someone think of the children?

I'll let you read the article yourselves, but suffice it to say that it very much feels like the NGS is more someone's little kingdom and power trip than it is an honest intention to actually provide healthcare. I'm OK, I have provision set up via providers elsewhere in Europe. But it hurts to hear stories from people who tried to do the right thing, who were brought up to trust their doctors, and who never had access to the information (or, for that matter, any idea that they might need access) necessary to go around the system. There is a myth that this is inherently dangerous, and that DIYing trans healthcare is analogous to taking illegal substances – this is absolute nonsense. The provider I'm currently working with for HRT follows WPATH guidelines and requires regular blood testing – ironically, this is something that no doctor ever did for me when I was going the conventional route.

As regards surgery, Ireland has no providers anyway. NGS will technically pay, or will sign off so insurance (e.g., VHI, if your plan covers it) will pay. But good luck with that. They make it impossible to get a referral elsewhere within Ireland, which blocks access to insurance. So, if you want or need surgery, you need to expect to pay. The better news is that this can be arranged outside Ireland by working directly with the providers. Many work on an informed consent model, and it is also possible to get a necessary diagnosis via overseas providers too. This can be put in place in weeks to months, so there is honestly zero requirement or need for years of torture and neglect.

Yes, torture. For a trans person, deciding to transition is a pivotal moment, and for many of us it can be a dangerous time. We are often shunned by family and friends, and being denied access to care can result in spiralling into a bad depression, which in all to many of us can end our lives.

So – just to be clear – this is the kind of shit we were up against before all the Trump/JKR/Tory/Starmer bullshit hit. I've heard life as a trans person being described as life on hard mode – cis people honestly have no idea. There is a myth that we have some kind of magical power that means we get stuff for free and get better treatment, DEI approved into jobs we aren't qualified for. This is such absolute garbage that it's hard to know where to even start. I've been denied access to healthcare, housing and education many times. I've been denied jobs and fired when people found out I'm trans. I've been made technically homeless twice (though was able to narrowly avoid ending up on the streets). I've been SA'd, raped, and survived an attempted murder. Now we have to contend with losing what tenuous rights we struggled to achieve over decades, just because some orange fuckhead decided to spend 200 million dollars on vilifying us because, like all fascists, he needs an internal enemy against which to rile his dumbass masses.

It's hard, and sometimes I wonder if I can go on, but then I bounce back and continue via sheer determination and no small amount of spite.